Pharmacology

Question 1

What are examples of short acting β2 agonists?

Answer 1

Salbutamol (albuterol)
Terbutaline
Metoproterenol
Pirbuterol

Question 2

What are examples of long acting β2 agonists?

Answer 2

Salmeterol
Formoterol
Vilanterol

Question 3

What are the adverse effects of using Salbutamol?

Answer 3

• Skeletal muscle tremor
• Restlessness, apprehension
• Tachycardia & other arrhythmias
• Relaxation of pregnant uterus

Question 4

What are anticholinergic agents/muscarinic agonists used in COPD and Asthma?

Answer 4

Ipratropium Bromide
Tiotropium
Umeclidinium

Question 5

What is the mechanism of of action for β2 receptor agonists?

Answer 5

*stimulation of adenylate cyclase
*increase levels of cAMP, myosin light-chain kinase phosphorylation & inactivation
*relaxation of smooth m & bronchodilation

Question 6

What is the mechanism of of action for Antichlolinergic?

Answer 6

Non-selective inhibition of acetylcholine at muscarinic (M 3) receptors on bronchial muscles —> relaxation of muscles

Question 7

What are the adverse effects of using anticholinergic agents in the treatment of asthma?

Answer 7

Bronchitis
COPD exacerbation
Sinusitis
Dyspnoea
Headache
Flu-like symptoms
Dry mouth

Question 8

What are the subdivisions of Bronchodilators?

Answer 8

β-agonists
Anticholinergic agents
Xanthine derivatives (Methylxanthines)

Question 9

What type of drugs are Theophylline
Aminophylline, Pentoxifylline?

Answer 9

Methylxanthine Derivatives

Question 10

Which methylxanthine drug is used in the treatment of Asthma?

Answer 10

Aminophylline
A- asthma

Question 11

What are the mechanism of actions for Methlxanthine derivatives?

Answer 11

• Inhibit phosphodiesterase in bronchial muscle →accumulation of cAMP → relaxation of bronchial muscle via ↓ intracellular calcium & ↑ rate of inactivation of myosin light chain kinase

*Blocks adenosine receptors (A 1) . Resulting in disinhibition of adenylate cyclase, leading to ↑ cAMP → bronchodilation & tachycardia

Question 12

Which subdivision of drugs are used as Anti-inflammatory agents in the treatment for Asthma and COPD?

Answer 12

*Glucocorticoids
*Mast cell stabilizers
*Inhibitors of leukotriene pathways
-Anti-leukotriene agents
-Leukotriene receptor antagonists

Question 13

What is the treatment for Acute Streptococcus Pharyngitis?

Answer 13

Penicillin & Erythromycin

Question 14

What can be used to treat Diphtheria?

Answer 14

Diphtheria antitoxin, Penicillin , Erythromycin

Question 15

When are corticosteroids used in Asthma management?

Answer 15

*Systemic steroids used primarily when attack is severe
* Usually by inhalation - may reduce need for β2 agonist

Question 16

Fill in the blank. _______ & ________ are examples of Oral corticosteroids?

Answer 16

Prednisone & Methylprednisolone

Question 17

What are examples of Inhaled Corticosteroids?

Answer 17

Beware- Beclomethasone propionate
Beryllium -Budesonide
Money -Mometasone furorate
Truck - Triamcinolone acetonide
Coming - Ciclesonide
Fast- Flunisolide
Friday- Fluticasone propionate

” Beware Beryllium Money Truck Coming Fast Friday”

Question 18

What classification of drugs inhibit Phospholipase A2 which causes a decrease in arachidonic and a decrease in prostaglandins and leuketrines?

Answer 18

Corticosteroids

Question 19

Which drugs inhibit the 5-lipoxygenase pathway which catalyzes formation of leukotrienes from arachidonic acid?

Answer 19

Zileuton

Question 20

Which drugs block the leuketrine D4 receptor (CysLTI)?

Answer 20

Montelukast & zafirlukast

Question 21

Which drugs are best used to treat Aspirin induced and Exercise -Induced asthma?

Answer 21

Montelukast & zafirlukast

Question 22

Which drug is a mast cell stabilizer that can be used in the treatment of Asthma?

Answer 22

Cromolyn / cromoglycate

Question 23

Which drug is a monoclonal antibody that can be used in th treatment of Asthma?

Answer 23

Omalizumab

Question 24

What are the major adverse effects of Leukotrine Inhibitors?

Answer 24

Neuropsychiatric effects, Headaches, GI distress, Hepatotoxity(Zileuton)

Question 25

What are examples of Decongestants?

Answer 25

*Oxymetazoline *Phenylephrine *Pseudoephedrine *Ephedrine

Question 26

What is the mechanism of Decongestants?

Answer 26

Stimulate α-adrenergic receptors - vasoconstriction of nasal vessels ↓ volume of nasal mucosa which causes opening of airways

Question 27

What are the adverse effects of Decongestants?

Answer 27

*Hypertension *Tachyarrhythmia *Rebound nasal congestion with repeated topical use (via down-regulation of receptors?)

Question 28

What type of drugs are used to treat Productive coughs?

Answer 28

Expectorants

Question 29

What type of drugs are used to treat Non-Productive (dry) coughs?

Answer 29

Antitussives/cough suppressants

Question 30

What are examples of Central acting Antitussives?

Answer 30

Opiates - Codeine Dextromethorphan

Question 31

Which central acting antitussive drug has mild opioid, ketamine,phencyclidine effect when used in excess and can cause an addictive state?

Answer 31

Dextromethorphan

Question 32

Which peripheral active antitussives are described as Demulcents?

Answer 32

Honey, glycerin, licorice (use syrups or lozenges(sweetie)

Question 33

What is another example of a peripheral acting antitussive ?

Answer 33

Humidifiers - ↓viscosity of bronchial secretions Water may be inhaled as aerosol or as steam with/without medicaments e.g. eucalyptus, sodium chloride

Question 34

What are some examples of Expectorants?

Answer 34

*Saline expectorants (e.g. potassium iodide, ammonium chloride, glycerol iodide, menthol) *Guaifenesin *Asmasol

Question 35

What is the moa for Expectorants?

Answer 35

Stimulate receptors in the gastric mucosa which reflexly increase glandular secretion of the respiratory epithelium  coating of mucosa + ease of removal of secretions

Question 36

Bromhexine , Ambroxol & N-acetylcysteine are what type of drugs?

Answer 36

Mucolytics

Question 37

Which drugs can be classified as First Generation Antihistamines

Answer 37

Diphenhydramine Dimenhydrinate Chlorpheniramine Cyproheptadine Cyclizine Promethazine

Question 38

What drugs can be classified as second generation antihistamines?

Answer 38

Laurie - Loratadine Leys - Levocetirizine Didn't - Desloratidine Come - Cetirizine First- Fexofenadine

Question 39

What is the moa for antihistamines?

Answer 39

*Competitively antagonize peripheral H1 receptors. *Smooth m: antagonizes constricting action of histamine ( notably at bronchial & vascular smooth m) *Capillaries: block ↑permeability that normally leads to oedema & wheal formation

Question 40

What is the clinical use for antihistamines?

Answer 40

*Allergic reactions: symptomatic treatment of IgE hypersensitivity, allergic rhinitis, urticaria *Motion sickness *Sleep aids (OTC)  “PM” preparations

Question 41

What's the difference between 1 st gen antihistamines and second gen antihistamines?

Answer 41

Second generation antihistamines causes less sedation than first generation.